Zoloft Side Effects And Warnings

Learn Facts About Zoloft, its Side Effects, and Associated Risks

Zoloft and Paxil Comparison

Zoloft and Paxil Comparison

Both Zoloft (sertraline) and Paxil (paroxetine) are antidepressants in a group of drugs called selective serotonin reuptake inhibitors (SSRIs). Both are usually prescribed to treat depression, anxiety disorder and panic disorder. Zoloft can be used by children while Paxil is not approved for people younger than 18 due to the risk of lung problems in babies. Some children may have suicide thoughts when first taking Paxil. Also, you should not use Paxil or Zoloft if you have epilepsy, liver or kidney disease, manic depression, or high blood pressure. Neither SSRIs should be suddenly stopped or else you will experience unwanted withdrawal symptoms such as sleeping disorders like insomnia, fatigue, headaches, irritability, nausea and mood swings which can lead to depression. If you feel restless, irritable, agitated or you have thoughts about hurting yourself during Zoloft or Paxil treatment, report these symptoms to your clinician.

The most common side effects of Paxil are major symptoms like agitation, chest pain, chills, weight gain, dizziness, irregular pulse and skin rash and minor side effects which do not need any medical care such as decreased appetite, heartburn, runny nose and trouble sleeping. When it comes to Zoloft treatment, you could experience the same side effect as in Paxil therapy plus some others including breast tenderness, loose stools, tingling feelings and bladder pain. Decreased libido and delayed ejaculation are two sexual disorders found in both drugs[1]. Paxil leads to the highest rate of sexual dysfunctions and it produces more delayed ejaculations and orgasms than Zoloft.

When it comes to weight gain, both antidepressants increase body weight after 6-12 months of therapy[2]. Paxil causes a significant weight increase while Zoloft is associated with less significant weight gain. Zoloft is more frequently associated with diarrhea than Paxil because sertraline has greater specificity for serotonin receptors. Other common side effect of these drugs is drowsiness and Paxil has the highest rate of somnolence than other SSRIs. Sertraline and paroxetine have similar effectiveness when it comes to major depression, while paroxetine is the only SSRI prescribed for all five anxiety disorders: generalized anxiety disorder, obsessive-compulsive disorder, panic disorder, post-traumatic stress disorder and social anxiety disorder[3]. Zoloft is more efficient in the treatment of panic disorder.

All SSRIs are classified as pregnancy category C medications, except Paxil, which is category D, which means that Zoloft is only suspected of causing harm to the fetus during pregnancy, while Paxil can cause babies to be born with serious birth defects and even autism. In 2005, JAMA Pediatrics established that Paxil is linked to a double rate of children born with autism by women who took this drug during the second or third trimester of pregnancy[4]. It also caused complications including premature birth, miscarriage, cranial defects, persistent pulmonary hypertension which is a serious condition in which there is not sufficient oxygen in child's lung's blood vessels. Zoloft's pregnancy category C indicates a slight risk of pregnancy complications, so women can take Zoloft while pregnant but they must respect the prescribed dose. Paxil is not prescribed to pregnant women at all.


  1. Montejo-Gonzalez A., Llorca G., Izquierdo J., Ledesma A., SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients, 1977
  2. Fava M., J Clin Psychiatry , Weight gain and antidepressants, 2000
  3. Kroenke K., West S., Swindle R., Gilsenan A., Eckert G., Dolor R., Stang P., Zhou X., Hays R., Weinberger M., Similar effectiveness of paroxetine, fluoxetine, and sertraline in primary care: a randomized trial, 2001
  4. Cipriani A., Furukawa T., Salanti G., Geddes J., Higgins J., Churchill R., Watanabe N., Nakagawa A., Omori I., McGuire H., Tansella M., Barbui C., Comparative efficacy and acceptability of 12 new-generation antidepressants: a multiple-treatments meta-analysis, 2009

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